Changes to the configuration of angiography equipment to reduce exposure to ionizing radiation in FGI procedures.

Angiography systems offer three dose rate modes (low, normal, and high) for performing fluoroscopy-guided interventional (FGI) procedures, with each mode corresponding to a specific set of parameters. Although the choice of mode should depend on the patient's biotype, such systems are typically shipped from the factory configured to start examinations in normal mode as the default. To reduce both the need for operator intervention during FGI procedures and the exposure of patients to ionizing radiation, we tested a change to the internal setup of an angiography machine in this study, in which the low-dose-rate mode was automatically selected as the default prior to starting a procedure. We analyzed 270 FGI dose reports, which were collected before and after modifying the machine's default setting. A Wilcoxon-Mann-Whitney test was used to assess whether this modification reduced the patient's exposure to ionizing radiation, and an analysis of the image quality was conducted. For procedures performed in the low-dose-rate mode, a significant reduction in the maximum entrance skin dose and air kerma-area product was observed. Following reconfiguration of the equipment, no significant differences were found in the total fluoroscopy time, number of exposures, or perceptions of image quality by clinical staff. This study demonstrates that changing the default angiography equipment configuration to the low-dose mode is a viable strategy for reducing patient radiation exposure during FGI procedures, without significantly increasing noise.